In the older D-R-A-B-C-D sequence chest compressions are often delayed while the responder opens the airway to give mouth-to-mouth breaths or retrieves a barrier device or other ventilation equipment. By changing the sequence to D-R-S-A-B-C-D, chest compressions will be initiated sooner and ventilation only minimally delayed until the completion of the first cycle of chest compressions (30 compressions should be accomplished in approximately 18 seconds).
The A.R.C
(Australian Resuscitation Council) has been reviewing data from
America and Europe following a 5 year study.
We
have always known that for C.P.R to be successful the operator had to
deliver adequate compressions to the chest and for this to do
perfectly the operator has to went through the <a
href="http://firstaidcourseonline.com.au/CPRCourse.asp">CPR
Course</a> or
CPR training. The current research has now shown that the focus
really must be about the compressions.
The means
compressions come first! Remember the point of C.P.R is to move
oxygen via the blood around the body; the body contains enough oxygen
in the blood to last for at least 4 minutes without extra oxygen
being supplied. Hence, by commencing compressions immediately the
transport of blood continues and you then supply oxygen via 2 breaths
following the first 30 compressions.
As of mid January
our new Basic Life Support Flow chart looks like this:
Danger:
check for any dangers to you, the bystanders or your causality.
Response:
Check for any response by using “touch & talk”
Send
for Help: If there is no clear signs of Response, send for help
ASAP. The first 10 minutes are critical
Airway:
Check if the airway is blocked, if any signs of fluids roll them on
the side to clear it.
Breathing:
When checking the Airway, check for signs of normal breathing, this
will take about 10 seconds
Compressions:
If no normal breathing, give 30 compressions at a rate of 2 per
second. For an adult you MUST push at least 5cm (about a match
box).
Defibrillation:
Attach a Defibrillator (A.E.D) ASAP and follow the prompts.
So why change it
again??
We know we can hold
our breath for 3 to 5 minutes without any brain damage or damage to
other organs or cells, but what they do need is the blood that
contains the oxygen moved around their body with the help of our
compressions.
DONT delay the
compressions. Now after checking for a response and calling for help
if there is no NORMAL
BREATHING
we begin with compressions, this ensures the rapid movement of what
remains of the oxygen contained within the blood.
Often first aiders
are concerned about opening the airway, finding a mask lost in the
glovebox or buried deep in their purse or even worse, the feeling of
"ick" at having to put their lips onto those of a stranger,
with or without vomit. This all takes time, time the casualty does
not have.
In summary it is
best explained like this:
In the older
D-R-A-B-C-D sequence chest compressions are often delayed while the
responder opens the airway to give mouth-to-mouth breaths or
retrieves a barrier device or other ventilation equipment. By
changing the sequence to D-R-S-A-B-C-D, chest compressions will be
initiated sooner and ventilation only minimally delayed until the
completion of the first cycle of chest compressions (30 compressions
should be accomplished in approximately 18 seconds).
Other
considerations that HAVE changed
Push a little
harder.
How deep you should push on the chest has changed for adult CPR. It
was 4-5 cm, but now you should push at least
5cms
deep in to the chest of an adult.
Push a little
faster.
Instead of pushing on the chest at about
100 compressions per minute, you should to push at
least
100 compressions per minute. At that rate, 30 compressions should
take you only 18 seconds.
Don't stop
pushing.
Every interruption in chest compressions interrupts blood flow to
the brain, which will lead to brain death if the blood flow is
interrupted for too long. It takes several chest compressions (about
20) to get blood pressure to the level that is affective. You should
keep pushing as long as you can. Push until an A.E.D is in place and
ready to analyse the heart. When it is time to perform mouth to
mouth, do it quick and commence compressions again immediately.
One
thing that has not changed is the simple but very true motto of the
A.R.C
"Any
attempt at resuscitation is better than no attempt at all"
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| About the author |
About Author - Peter Mcgreal
Director of Immediate Response First Aid Training and Supplies. Peter has been operating Immediate Response First Aid Course and CPR Course since 2006.
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